Flying High: Back in the Cockpit After a Head Injury

Newswise — Aviators are expected to be in the best shape, both physically and mentally, but what happens when a pilot suffers an injury that affects his or her mental skills? The path back to the cockpit involves many medical examinations and neuropsychological evaluations. In a new study, a University of Missouri-Columbia researcher argues that evaluators may be comparing pilots to the general population when approving their fitness to fly and this comparison might be problematic.

"Military aviators score significantly higher on standardized intelligence tests than the average person," said Daniel Orme, a clinical assistant professor of health psychology. "Evaluators use aviator specific norms when they can, but many tests do not have aviator specific norms. On average, aviators perform at the same level as physicians, so these are very bright individuals."

This means pilots represent a unique population making it very important to compare their test scores with samples from their peers and not the general population. When pilots are evaluated after sustaining head trauma, they are subjected to extensive evaluations including a battery of intelligence tests to determine if they can manage the demands of flying.

In Orme's study, data was collected from testing more than 5,600 participants over a five-year period at Brooks Air Force Base in San Antonio. All subjects were active duty United States Air Force personnel, Air Force Academy students or graduates from the Air Force Reserve Officer Training Corps. The Air Force will publish the results of the study as a "tech report" so these test score tables will be available for all evaluators soon. Orme said the Federal Aviation Administration also could use these same norms when evaluating commercial pilots. This new tool for evaluators could help ensure that an impaired pilot would not be allowed to return to the cockpit.

"They always feel like they can do it," Orme said. "That's why such a large burden is placed on the evaluators. A pilot suffering cognitive impairment from a head injury could still test above the norm when compared to the general population. However, concern would be raised if test scores are below expectations based on pilot standards. This information would be incorporated into findings of an extensive, multidisciplinary medical evaluation, the outcome of which would be a recommendation whether or not to return to flying."

A pilot allowed back in the cockpit because of a missed diagnosis would place themselves, other aircrew and the mission in jeopardy. Head trauma or other injuries that affect mental skills are not that uncommon according to Orme.

"The military is full of young people who are very active," he said. "They are put in positions of incredible responsibility."